The Relationship Between Prognostic Nutritional Indexes and the Clinical Outcomes of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Purpose

Nutritional status is related to the clinical outcomes of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The aim of this study was to investigate the association between nutritional status, measured by the prognostic nutritional index (PNI), and adverse hospitalization outcomes in patients with AECOPD.

Methods

Consecutive AECOPD patients admitted to the First Affiliated Hospital of Sun Yat-sen University between January 1, 2015 to October 31, 2021 were enrolled. We collected the clinical characteristics and laboratory data of patients. Multivariable logistic regression models were developed to assess the relationship between the baseline PNI and adverse hospitalization outcomes. A generalized additive model (GAM) was used to identify any non-linear relationship. In addition, we performed a subgroup analysis to tested the robustness of the results.

Results

A total of 385 AECOPD patients were involved in this retrospective cohort study. Based on the tertiles of PNI, patients in the lower tertiles of PNI showed more worse outcome incidence (30 [23.6%] versus 17 [13.2%] versus 8 [6.2%]; p < 0.001). Multivariable logistic regression analysis revealed that the PNI were independently associated with adverse hospitalization outcomes after adjustment for confounding factors (Odds ratio [OR] = 0.94, 95% CI: 0.91 to 0.97, P < 0.0001). After adjusting for confounders, smooth curve fitting showed a saturation effect, suggesting that the relationship between the PNI and adverse hospitalization outcomes was nonlinear. Two-piecewise linear regression model suggested that the incidence of adverse hospitalization outcomes significantly decreased with PNI level up to the inflection point (PNI = 42), and PNI was not associated with adverse hospitalization outcome after that point.

Conclusion

Decreased PNI levels at admission were determined to be associated with adverse hospitalization outcomes in patients with AECOPD. The results obtained in this study may potentially assist clinicians optimize risk evaluations and clinical management processes.

Karst tiankeng shapes the differential composition and structure of bacterial and fungal communities in karst land

Karst tiankeng are important biodiversity conservation reservoirs. However, the unique habitats of karst tiankeng affect microbial community structure remained poorly understood. In this study, we collected soil samples from karst tiankeng (TK) and karst land (KL) and subjected to high-throughput sequencing. Based on the classification of the total, abundance, and rare taxa for bacteria and fungi, a multivariate statistical analysis was carried out. The results revealed that bacterial community Shannon diversity and Pielou's evenness were highest in TK. The rare taxa were ubiquitous in all soil samples, while the higher Shannon diversity of the abundant taxa of TK may be related to the habitat preferences of species and niche differentiation. The community composition of bacterial and fungal sub-communities exhibited significant dissimilarity between TK and KL. The redundancy analysis further demonstrated that abundant taxa were environmentally more constrained than rare taxa. The bacterial and fungal networks of KL were more complex than TK. The keystones of the network transforms may suggest their significant role in the ecological function of the karst tiankeng ecosystem. This study represents the first reports of the characteristics of bacterial and fungal communities in karst tiankeng.

Spatiotemporal responses of habitat quality to land use changes in the source area of Pearl River, China

Habitat quality assessment provides an effective interface for exploring the mechanisms linking land use change and biodiversity. We used InVEST model to assess the spatial and temporal variations of habitat quality in the Pearl River source area from 2000 to 2020, and to examine the impacts of land use change on habitat quality. The results showed that during the study period, construction land had the largest change, with an area increase of 321.48 km², and the area of grassland decreased most significantly. Habitat quality in the Pearl River source area was generally at a high level, with a small downward trend. The low value areas were concentrated in the town centers and main agricultural production areas, while habitat quality was high in the mountainous areas in the south and north region. The cold spots of habitat quality change had the most significant aggregation effect in the Quzhan Basin along the Nanpan River. The number of hot spots was small and scattered. Among the various types of nature reserves, habitat quality of Jiache Nature Reserve in Huize County was the lowest, and that of Zhujiangyuan Nature Reserve had a slight decreasing trend, mainly due to the transformation of grassland to cropland. The contribution of habitat quality degradation driven by land function change was 5.6 times as that of improvement. The encroachment of urban and rural construction space into grassland ecological space and agricultural production space was the dominant factor driving the reduction of habitat quality in the Pearl River source area. The contribution of construction land expansion decreased from 69.9% (2000-2010) to 46.7% (2010-2020). The expansion of construction land was the main cause for the degradation of habitat quality. The degradation threat from arable land expansion overtook the traffic network construction as the secondary threat source from 2010 to 2020. It was necessary to increase control of nature reserves in the Pearl River source area and to implement land use regulation strictly to guarantee no net loss and integrity of the ecosystem.

Synergistic Function between Phosphorus-Containing Flame Retardant and Multi-Walled Carbon Nanotubes towards Fire Safe Polystyrene Composites with Enhanced Electromagnetic Interference Shielding

As a universal polymer material, polystyrene (PS) is widely applied in electrical devices and construction. Thus, it is necessary to improve the flame retardancy and electromagnetic shielding properties of PS material. In this work, PS/silicon-wrapped ammonium polyphosphate/Inorganic acid-treated multi-walled carbon nanotubes composites (PS/SiAPP/aMWCNT, abbreviated as PAC) were prepared via methods of filtration-induced assembly and hot-pressing. Morphology and structure characterization demonstrated that SiAPP and aMWCNT had good dispersion in PS and excellent compatibility with the PS matrix. Thermogravimetric analysis revealed that the addition of aMWCNT to PS improved its thermal stability and carbon-forming characteristics. The peak heat release rate, the peak carbon monoxide production rate, and the peak smoke production rate of the PAC10 composite decreased by 53.7%, 41.9%, and 45.5%, respectively, while its electromagnetic shielding effectiveness reached 12 dB. These enhancements were attributed to the reason that SiAPP and aMWCNT synergistically catalyzed the char generation and SiAPP produced free radical scavengers and numbers of incombustible gases, which could decrease the oxygen concentration and retard the combustion reaction. Therefore, the assembled PS/SiAPP/aMWCNT system provides a new pathway to improve the flame retardant and electromagnetic shielding properties of PS.

Urban heat vulnerability: A dynamic assessment using multi-source data in coastal metropolis of Southeast China

Extreme heat caused by global climate change has become a serious threat to the sustainable development of urban areas. Scientific assessment of the impacts of extreme heat on urban areas and in-depth knowledge of the cross-scale mechanisms of heat vulnerability forming in urban systems are expected to support policymakers and stakeholders in developing effective policies to mitigate the economic, social, and health risks. Based on the perspective of the human-environment system, this study constructed a conceptual framework and index system of "exposure-susceptibility-adaptive capacity" for urban heat vulnerability (UHV) and proposed its assessment methods. Taking Xiamen City, a coastal metropolis, as an example, spatial analysis and Geodetector were used to explore the spatial and temporal changes, spatial characteristics, and patterns of UHV under multiple external disturbances from natural to anthropological factors, and to reveal the main factors influencing UHV forming and spatial differentiation. Results showed that the exposure, susceptibility, adaptive capacity, and UHV in Xiamen City had a spatial structure of "coastal-offshore-inland". On the hot day, both the exposure and UHV showed a temporal pattern of "rising and then falling, peaking at 14:00" and a spatial pattern of "monsoonal-like" movement between coast and inland. Coastal zoning with favorable socioeconomic conditions had less magnitude of changes in UHV, where the stability of the urban system was more likely to be maintained. During the hot months, the high UHV areas were mainly distributed in the inland, while coastal areas showed low UHV levels. Further, coastal UHV was mainly dominated by "heat exposure", offshore by "comprehensive factors", and inland in the northern mountainous areas by "lack of adaptive capacity". Multi-scale urban adaptive capacity was confirmed to alter spatial distribution of exposure and reshape the spatial pattern of UHV. This study promotes the application of multi-scale vulnerability framework to disaster impact assessment, enriches the scientific knowledge of the urban system vulnerability, and provides scientific references for local targeted cooling policy development and extreme heat resilience building programs.

The characterization of microbial communities and associations in karst tiankeng

The karst tiankeng is a special and grand negative terrain on the surface, that maintains a unique ecosystem. However, knowledge about bacterial and fungal communities in karst tiankengs is still limited. Therefore, soil samples from five karst tiankengs were collected and subjected to high-throughput sequencing of 16S rRNA and ITS genes, and multivariate statistical analysis. The results showed abundant and diversified bacterial and fungal communities in karst tiankeng. The bacterial communities were dominated by Proteobacteria and Acidobacteria, and the fungal communities were dominated by Ascomycota and Basidiomycota. Statistical analysis revealed significant differences in bacterial and fungal communities among the five karst tiankengs, which may indicate that the distribution of bacterial and fungal communities was driven by separate karst tiankengs. The co-occurrence network structure was characterized by highly modularized assembly patterns and more positive interactions. The keystone taxa were mainly involved in nutrient cycling and energy metabolism. The null model analysis results showed that the stochastic process, especially dispersal limitation, tended to be more important in controlling the development of bacterial and fungal communities in karst tiankeng. The bacterial community structure was significantly associated with soil properties (SWC, TN, AN, and BD), while the fungal community structure was significantly associated with soil properties (SWC and TP) and plant diversity. These results can expand our knowledge of the karst tiankeng microbiome.

Association of Red Cell Index and Adverse Hospitalization Outcomes in Chronic Obstructive Pulmonary Disease Patients with Acute Exacerbation: A Retrospective Cohort Study

Purpose

Previous studies have shown that the red cell index (RCI) can be considered as a simple and useful method to evaluate respiratory function. However, at present its association with adverse hospitalization outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is not fully understood. Our study aimed to examine the relationship between adverse hospitalization outcomes and RCI among AECOPD patients.

Patients and Methods

We performed a retrospective analysis of consecutive patients from January 2015 to October 2021. In this study, RCI was the independent variable, measured at baseline, and adverse hospitalization outcome was the dependent variable. According to the RCI median (RCI=2.221), we divided 377 patients into two roughly equal groups (188 and 189, respectively). Next, the association between RCI and adverse hospitalization outcomes was explored using multivariable logistic regression models. To identify any non-linear relationship, a generalized additive model (GAM) was employed.

Results

With a total of 377 patients with AECOPD, we divided them into two roughly equal groups to compare the clinical factors and RCI levels. The patients in the higher RCI group showed poorer outcome incidence (18 [9.57%] vs 31 [16.40%]; p = 0.049). After accounting for potential confounders, the results showed that RCI was positively associated with adverse hospitalization outcomes (odds ratio [OR] = 1.15, 95% CI: 1.01-1.32). In addition, a non-linear relationship was detected between RCI and adverse hospitalization outcomes, which had an inflection point of 3.2. There were odds ratios and confidence intervals of 0.8 (0.7-1.0) and 1.3 (1.2-1.4) on the left and right sides of the inflection point, respectively.

Conclusion

The RCI and adverse hospitalization outcomes exhibited a non-linear relationship in the AECOPD patients. RCI is strongly positively correlated with adverse hospitalization outcomes when it was greater than 3.2.

Are degraded karst tiankengs coupled with microclimatic underground forests the refugia of surface flora? Evidence from China’s Yunnan

Karst tiankengs, as one of the most magnificent negative topographies, are capable of forming a bank for species diversity conservation easily. More than 300 karst tiankengs have been discovered and identified worldwide. Given its treacherous terrain, although original karst tiankeng were identified as species refuges, the broader distribution of degraded karst tiankeng has not been systematically studied. Our study area comprised the degraded karst tiankeng cluster immersed in the fragmented karst forests of Yunnan, China. Fifty-eight plant samples were selected from karst tiankengs and surface. We compared species composition, and analyzed diversity indices and similarity coefficients to verify the isolation effect of karst tiankengs on floras. The results indicated that: (1) In the degraded karst tiankeng, there were 24 families, 37 genera and 48 species in the tree layer and 27 families, 43 genera and 49 species in the shrub layer. Outside the degraded karst tiankengs, 20 families, 31 genera and 39 species were in the tree layer, and the shrub layer included 26 families, 44 genera and 55 species. (2) The species composition reached significant differences within and outside degraded karst tiankeng (p &lt; 0.05) based on the analysis of variance (ANOVA). (3) In the degraded karst tiankeng, species richness/diversity in trees were higher than those in the shrub layer, while at the surface, shrubs had higher richness and lower diversity than trees by Alpha-diversity index. And for Beta-diversity index, species similarity among degraded karst tiankengs (0.215) was extremely dissimilar, which was even lower than the contrast within and outside the degraded karst tiankengs (0.272). (4) Shared species ranged from 1 to 5 among the four habitats, with high variability in plant species across the habitat matrices. Through a comparative analysis of systematic biodiversity methods, we found that the degraded karst tiankengs, an independent type of karst tiankeng, are the unreported refugia. Species records in degraded karst tiankeng cluster will contribute to plant diversity conservation and resource management, and to the linkage with broader China’s karst floras. Karst tiankeng botanical habitats possess not only biodiversity value for in situ conservation, but will further support the ecological recovery of surface flora. While its mechanism needs to be further revealed.

Does Tibetan Household Livelihood Capital Enhance Tourism Participation Sustainability? Evidence from China’s Jiaju Tibetan Village

Identifying effective transformations to reduce poverty and approach rural sustainability is at the core of the first sustainable development goal of the United Nations. This article offers scientific support for continued efforts in sustaining rural development and livelihood resilience. Many studies have examined drivers of livelihood transition from farming to non-farm activities, especially participation in tourism against the backdrop of rural tourism development. However, few studies have identified ways to measure the level of tourism participation or have discussed how household-level capital influences decisions regarding tourism participation made by Tibetan ethnic households. This article assesses the role of livelihood capital in the adoption of tourism activities at the household level in Jiaju Tibetan Village, an ethnic region that is experiencing struggling agricultural business and developing tourism sector. Using household survey data, this study presents an ordinal logistic regression model to identify the determinants of the household tourism participation level. The results showed that households’ tourism participation was influenced by physical capital (e.g., proximity to major roads, odds ratio = 2.83 at p = 0.024; fixed capitals, odds ratio = 101.19 at p = 0.039), human capital (e.g., availability of family labor, odds ratio = 0.25 at p = 0.004; availability of skilled member, odds ratio = 2.91 at p = 0.002), and social capital (e.g., relatives in governmental sectors, odds ratio = 5.22 at p = 0.044; government payments, odds ratio = 8.78 at p = 0.04), while the influence of financial capital was not significant. The proximity to major roads, availability of skilled members, fixed assets, and direct and indirect support from the government to households were significantly and positively associated with tourism participation level. The effects of household labor availability and annual family income remain unclear. Overall, household livelihood capital plays a critical role in the enhancement of tourism participation in Jiaju Tibetan Village. Our findings have implications for understanding the shift of on-farm occupation to off-farm activities in tourism and for the pursuit of policies contributing to poverty reduction and rural revitalization in China as well as to the Sustainable Development Goals.

Original karst tiankeng with underground virgin forest as an inaccessible refugia originated from a degraded surface flora in Yunnan, China

Karst tiankengs are rare natural habitats, having a local microclimate different from surrounding regions. A contrast study on plant communities at the inside and outside of the primitive tiankeng was carried out by performing the qualitative analysis of species compositions of arborous and shrub layers. We found that plant communities in the primitive tiankeng belong to the subtropical moist evergreen broad-leaf forest, whereas those outside the tiankeng belong to subtropical semi-moist needle-broadleaved mixed forest. Trapped habitat of primitive karst tiankeng protects the plant communities significantly different from those in external karst ecosystems, so karst tiankeng has the great value in the plant species protection. Although the trapped habitat decreases plant species abundance inside tiankeng to some extent, highly diverse shrub species are present in the inside-tiankeng plant communities, and the primitive karst tiankeng plays an important role in the plant diversity protection. The primitive karst tiankeng is an important refugia for plant not only as a plant species protection library, but a plant diversity protection library. When implementing measures for the reduction of damages to biodiversity due to global climate changes and human activities, more attention should be paid to the primitive karst tiankeng as a small ecological refugia and biodiversity protection library.

Slope aspect affects the soil microbial communities in karst tiankeng negative landforms

Background

Karst tiankeng is a large-scale negative surface terrain, and slope aspects affect the soil conditions, vegetation and microbial flora in the tiankeng. However, the influence of the slope aspect on the soil microbial community in tiankeng has not been elucidated.

Methods

In this study, metagenomic sequencing technology was used to analyze the soil microbial community structure and functional potentials on the shady and sunny slopes of karst tiankeng.

Results

The Shannon–Wiener diversity of microbial communities on shady slope (SHS) was significantly higher than that on sunny slope (SUS). Although the composition of dominant phyla on shady slope (SHS) and sunny slope (SUS) was similar, there were significant differences in beta-diversity. The linear discriminate analysis (LDA) results showed that biomarkers mainly belongs to Actinobacteria, Chloroflexi and Proteobacteria. Functional pathways and CAZy (Carbohydrate-Active Enzymes) genes also had a remarkable response to slope aspect change. LEfSe results indicated several biomarker pathways in sunny slope involved in human disease. Moreover, the abundance of CAZy genes was higher in shady slope and had stronger ability in decomposing litter. The microbial communities were mainly correlation with the vegetation characteristics (species richness and coverage) and soil properties (SOC and pH).

Conclusions

These results indicate slope aspect has a pronounced influence on microbial community composition, structure and function at karst tiankeng. In the future, the conservation of karst tiankeng biodiversity should pay more attention to topographical factors.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12862-022-01986-y.

Metagenomic analysis reveals the different characteristics of microbial communities inside and outside the karst tiankeng

Background

Karst tiankengs serve as a reservoir of biodiversity in the degraded karst landscape areas. However, the microbial diversity of karst tiankengs is poorly understood. Here, we investigated the composition and function of the microbial community in a karst tiankeng.

Results

We found that habitat differences inside and outside the karst tiankeng changed the composition and structure of the soil microbial communities, and the dominant phyla were Proteobacteria, Actinobacteria, Chloroflexi and Acidobacteria. The Shannon–Wiener diversity of microbial communities inside and outside the tiankeng was significantly different, and it was higher inside the tiankeng (IT). Venn and LEfSe analysis found that the soil microbial communities inside the tiankeng had 640 more endemic species and 39 more biomarker microbial clades than those identified outside of the tiankeng (OT)..Functional prediction indicated that soil microorganisms in outside the tiankeng had a high potential for carbohydrate metabolism, translation and amino acid metabolism. There were biomarker pathways associated with several of human diseases at both IT and OT sites. Except for auxiliary activities (AA), other CAZy classes had higher abundance at IT sites, which can readily convert litter and fix carbon and nitrogen, thereby supporting the development of underground forests. The differences in microbial communities were mainly related to the soil water content and soil total nitrogen.

Conclusions

Our results provide a metagenomic overview of the karst tiankeng system and provide new insights into habitat conservation and biodiversity restoration in the area.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12866-022-02513-1.

An improved daily standardized precipitation index dataset for mainland China from 1961 to 2018

The standardized precipitation index (SPI), one of the most commonly used drought indicators, is widely used in the research areas of drought analysis and drought prediction in different fields such as meteorology, agriculture, and hydrology. However, its main disadvantage is the relatively coarse time resolution of one month. To improve the time resolution of SPI to identify flash droughts, we have refined the traditional SPI calculation method and developed a new multi-scale daily SPI dataset based on data from 484 meteorological stations in mainland China from 1961 to 2018. SPI data from three different sites (located in Henan, Yunnan, and Fujian Provinces) at the three-month timescale were analyzed by comparing with historically recorded drought events. We found that the new multi-scale daily SPI can effectively capture drought events in different periods and locations and identify the specific start and end times of drought events. In short, our SPI dataset appears reasonable and capable of facilitating drought research in different fields.

Heat Adaptive Capacity: What Causes the Differences Between Residents of Xiamen Island and Other Areas?

Extreme heat events caused by climate change have serious adverse effects on residents' health in many coastal metropolises in southeast China. Adaptive capacity (AC) is crucial to reduce heat vulnerability in the human-environment system. However, it is unclear whether changes in individual characteristics and socioeconomic conditions likely amplify or attenuate the impacts of residents' heat adaptive capacity (HAC) changes. Moreover, which public policies can be implemented by the authorities to improve the HAC of vulnerable groups remains unknown. We conducted a questionnaire survey of 630 residents of Xiamen, a typical coastal metropolis, in 2018. The effects of individual and household characteristics, and government actions on the residents' HAC were examined by using ordinal logistic regression analysis. Results show that the majority (48.10%) of Xiamen residents had a "medium" HAC level, followed by a "high" level (37.14%). On Xiamen Island, residents who settled locally for one-three years and spent less than one hour outdoors might report weaker HAC, and their HAC would not improve with increased air conditioning units in household. In other areas of Xiamen, residents with more rooms in their households, no educational experience, and building areas <50 m2 might report better HAC. Further, vulnerable groups, such as local residents and outdoor workers on Xiamen Island, people lacking educational experience and renters in other areas of Xiamen, showed better AC to hot weather than those in previous studies. Low-income groups should be given more attention by local governments and community groups as monthly household income played a positive role in improving Xiamen residents' HAC. Rational green spaces planning and cooling services, such as street sprinkling operations, provided by municipal departments can effectively bring benefits to Xiamen residents. Identification of basic conditions of AC has significant implications for practical promoting targeted measures or policies to reduce health damages and livelihood losses of urban residents during extreme heat events.

Constructing segregated polystyrene composites for excellent fire resistance and electromagnetic wave shielding

Electroconductive polystyrene (PS) composites with ideal flame-retardant properties are considered as potential electromagnetic interference (EMI) shielding materials. In this work, PS/silicon wrapped ammonium polyphosphate/multi-wall carbon nanotubes (PS/SiAPP/MWCNT) composites with segregated structure were synthesized via the methods of balling mill and hot-pressing. The obtained results revealed that the SiAPP and MWCNT were successfully introduced onto PS spheres and showed uniform distribution on the PS surface. The thermogravimetric analysis showed that PS/SiAPP/MWCNT containing 7 wt% MWCNT exhibited excellent thermal stability. Furthermore, the results of cone calorimeter test indicated that the heat release rate and total heat release of the PS/SiAPP/MWCNT containing a loading of 7 wt% MWCNT were reduced by 60.5% and 33.9%, respectively. In addition, the EMI shielding performance could reach 11 dB. Above results implied that the synergistic effect between the MWCNT and SiAPP effectively enhanced the flame retardant performance of the PS by promoting the generation of dense and continuous char layer to protect the PS from burning. The multiple reflection and adsorption are responsible for improved EMI shielding effectiveness. Therefore, segregated PS/SiAPP/MWCNT hybrid is an up-and-coming candidate for satisfactory EMI shielding materials with exceptional fire retardancy for electronic devices.

[Effectiveness of arthroscopic 360° capsular release for frozen shoulder]

Objective

To investigate the effectiveness of arthroscopic 360° capsular release for frozen shoulder.

Methods

Between April 2018 and April 2019, 42 patients with frozen shoulders were treated with arthroscopic 360° capsular release. There were 13 males and 29 females, with an average age of 52.3 years (range, 45-56 years). There were 14 left shoulders and 28 right shoulders. The disease duration ranged from 5 to 18 months (mean, 11.1 months). The main clinical symptoms were limited active and passive movement of the shoulder joint with severe pain. All patients excluded impingement syndrome and shoulder osteoarthritis. Preoperative range of motion was as follows: forward flexion (93.2±15.4)°, external rotation at side (15.9±6.0)°, external rotation at 90° abduction (18.4±9.9)°, and internal rotation reaching the greater trochanter in 5 cases, buttocks in 20 cases, S ₁ level in 17 cases. The visual analogue scale (VAS) score was 6.7±1.7 and the American Society of Shoulder and Elbow Surgery (ASES) score was 41.6±9.3. The active range of motion of shoulder joint, VAS score, and ASES score were recorded during follow-up.

Results

All incisions healed by first intention, and no early complications occurred. Patients were followed up 12-24 months (mean, 15.6 months). After operation, forward flexion, external rotation at side, and external rotation at 90° abduction significantly improved when compared with preoperatively ( P<0.05). The range of internal rotation restored to the level of T _6-12 at 3 weeks, which was equivalent to that of the normal side at 12 months after operation ( Z=-0.943, P=0.346). VAS scores decreased and ASES scores increased after operation, and the differences between pre- and post-operation were significant ( P<0.05); and with time, the VAS scores and ASES scores improved further ( P<0.05).

Conclusion

Arthroscopic 360° capsular release can significantly increase the range of motion of the shoulder joint, release pain, and improve function. It is an effective method for the treatment of frozen shoulders.

Functional traits of Fagaceae plants in shady and sunny slopes in karst degraded tiankeng

In the negative terrain habitat of the karst degraded tiankeng, the shady and sunny slopes are dramatically different, which results in substantial variations in plant communities. With the degraded tiankeng Shenxiantang in Zhanyi, Yunnan as an example, we explored the functional traits of Fagaceae plants in the shady and sunny slopes, which would help reveal the value of tiankeng as species diversity conservation pool. The results showed that soil nutrients in the shady slope were more than those in the sunny slope. Leaf area, specific leaf area and leaf dry weight of Faga-ceae plants in the shady slope were significantly larger than those in the sunny slope. Leaf thickness was significantly lower than that in the sunny slope. Dry matter content of leaves was less than that of the sunny slope. The main environmental factors affecting functional traits of Fagaceae plants in the shady slope were soil total potassium concentration and soil moisture, while soil total phosphorus concentration was the key factor in the sunny slope. The extent of variation of leaf functional traits in shady slope was less than that in the sunny slope. Fagaceae plants mainly adapted to the shady slope habitat by changing the leaf dry weight to increase photosynthetic rate and carbon accumulation abi-lity. Sunny slope obtained more resource by keeping smaller specific leaf area and increasing the extent of variation of the leaf area. The succession rate of plant community in the shady slope of the degraded tiankeng Shenxiantang was significantly faster than that in the sunny slope. The dominance of Fagaceae plants gradually decreased in the shady slope, but remained to be the constructive species in the sunny slope.

Effect of Community-Acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Community-acquired pneumonia (CAP) is a major contributor to hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD). The clinical manifestations of AECOPD with and without CAP are confusing. The difference in the survival or readmission rate of AECOPD with or without CAP remains controversial. A prospective cohort study was conducted to evaluate the clinical and laboratory characteristics and in-hospital outcomes of patients who were consecutively hospitalized due to AECOPD from May 2015 to December 2019. Grouping was based on chest computed tomography findings. Multivariable logistic regression was used to explore the predictors for early identification between CAP exacerbations and non-CAP exacerbations. Kaplan-Meier analysis was used to compare the cumulative survival rate and readmission rate for a 12-month follow-up between the two groups. A total of 378 patients with AECOPD were enrolled, including 200 patients with CAP and 178 patients without CAP. The presence of pleuritic pain, usage of ICS, and elevated levels of C-reactive protein and procalcitonin on admission were the predictors for the early discrimination between AECOPD with and without CAP. During a 1-year follow-up, the cumulative survival rate was lower in patients with AECOPD with CAP than in those with AECOPD without CAP (13.0% vs. 3.37%; HR: 4.099; 95% CI, 2.049-8.199; p < 0.001), but the readmission rate was similar in both groups. Patients with first-time exacerbation due to CAP were more likely to experience subsequent pneumonic exacerbation. CAP is frequent among patients hospitalized for AECOPD and associated with increased mortality and successive pneumonic exacerbation.

A novel closed reduction technique for treating femoral shaft fractures with intramedullary nails, haemostatic forceps and the lever principle

Background

Faster, easier, more economical and more effective versions of the minimally invasive reduction procedure for femoral shaft fractures need to be developed for use by orthopaedic surgeons. In this study, a fracture table was used to restore limb length, and long, curved haemostatic forceps and the lever principle were utilized to achieve minimally invasive reduction and intramedullary nail fixation of femoral shaft fractures.

Methods

A retrospective analysis involving 20 patients with femoral shaft fractures reduced with a fracture table; long, curved haemostatic forceps; and the lever principle was conducted. The operative effect was evaluated on the basis of the operative time, reduction time, fluoroscopy time, and intraoperative blood loss.

Results

All 20 cases were reduced in a closed fashion, and no conversions to open reduction were needed. The average operative time and fracture reduction time for all patients were 69.1 ± 13.5 min (range, 50–100 min) and 6.7 ± 1.9 min (range, 3–10 min), respectively. The fluoroscopy exposure time during the reduction process was 5–15 s, with an average time of 8.7 ± 2.7 s. The average intraoperative blood loss was 73.5 ± 22.5 mL (range, 50–150 mL). The patients exhibited excellent alignment in the injured limb after intramedullary nailing. Seventeen patients successfully completed a follow-up after fracture healing. The healing time ranged from 4 to 6 months.

Conclusions

Displaced femoral shaft fractures in adults can be treated by a labour-saving lever technique involving fragments, 2 haemostatic forceps and soft tissue envelope-assisted closed reduction and intramedullary nail fixation. This technique is easy to perform; reduces blood loss, the fluoroscopy time and the surgical time for intraoperative reduction; and leads to excellent fracture healing.

[Spatial Differentiation and Driving Analysis of Nitrogen in Rice Rotation Based on Regional DNDC: Case Study of Jinjiang River Watershed]

Cycling dynamics of nitrogen in paddy rotation areas have a practical significance for ensuring food supply and realizing sustainable development of the regional ecology in the Min delta urban agglomeration. However, with rapid urbanization, the negative externalities of paddy rotation areas have been gradually increased because of unreasonable utilization behavior, and the environmental costs are increasing. Therefore, the spatial differentiation of nitrogen indicators and its driving factors were analyzed, which provides a macro-decision making basis for the implementation of farmland management measures. In this study, the paddy rotation area in Jinjiang River watershed was selected as the research object. The denitrification decomposition (DNDC) model was used to simulate the nitrogen cycle in the paddy rotation area. The hot spot analysis and geographical weight regression (GWR) model were used to analyze the spatial otherness characteristics and driving attribution of various nitrogen indices. The main results showed that: ① The DNDC model was validated by parameters, and the results showed preferably regional adaptability. ② Based on the comparison of different rotation patterns, the rice-vegetable rotation pattern not only established the maximum input of nitrogen fertilizer but also revealed the highest nitrogen absorption efficiency and the maximum values of nitrogen loss, followed by the rice-rice rotation pattern and rice-fallow rotation pattern. ③ In the spatial distribution of nitrogen indicators, except for the crop nitrogen absorption, the NH₃ emission, N₂O emission and nitrogen leaching showed a spatial clustering distribution, and the main trend line based on the standard deviation ellipse was mainly "Gande-Changkeng" township.④ According to the analysis of spatial influence factors for various nitrogen indices, soil attribute factors had the strongest effect; the SOC_max was the strongest influential factor for both NH₃ and N₂O emissions, and the spatial distribution was "west high, east low". The pH_min was the strongest influential factor in nitrogen leaching, and the spatial distribution was "north and south high, east and west low".

Self-adapting extraction of cropland phenological transitions of rotation agroecosystems using dynamically fused NDVI images

Remote sensing can be used to monitor cropland phenological characteristics; however, tradeoffs between the spatial and temporal resolutions of cloudless satellite images limit the accuracy of their retrieval. In this study, an improved enhanced spatial and temporal adaptive reflectance fusion model (ESTARFM) was applied to human-dominated Xiong'an New Area to develop a self-adapting algorithm automating the extraction of main phenological transition points (greenup, maturity, senescence, and dormancy). The analyses of cropland phenological characteristics were performed utilizing the Softmax classification method. By examining three different phases of fusion images, it was found that the improved ESTARFM was more accurate than the original ESTARFM (correlation coefficient > 0.76; relative root mean square error < 0.25; structural similarity index > 0.79). The reconstructed normalized difference vegetation indexes were consistent with that acquired by the Moderate Resolution Imaging Spectroradiometer (average discrepancy: 0.1136, median absolute deviation: 0.0110). The greenup, maturity, senescence, and dormancy points were monitored in 5-day resolution and 50-day length on a 30-m grid scale, and their average day of year (DOY) were 67, 119, 127, and 166 for wheat; 173, 224, 232, and 283 for single-season corn; and 189, 227, 232, and 285 for rotation corn, respectively. The corresponding median absolute deviations were 2, 3, 2, and 2 days for wheat; 2, 5, 3, and 4 days for single-season corn; and 2, 5, 2, and 2 days for rotation corn, respectively, while all coefficients of variation did not exceed 6%. The proposed self-adapting approach can be used for identifying the planting modes at grid level in rotation agroecosystems and cropland phenological dynamics on a global or regional scale.

[Vertical distribution characteristics of plant community in shady slope of degraded tiankeng talus: A case study of Zhanyi Shenxiantang in Yunnan, China]

We investigated the characteristics of plant species diversity in tree and shurb layers and the main influencing factors in different slope positions of a shady slope of degraded tiankeng talus. The results showed that there were 21 species in 17 genera and 13 families in the tree layer, and 20 species in 20 genera and 14 families in shrub layer in the south side of the Shenxiantang. Plant communities were subtropical moist coniferous and broad-leaved mixed forest. Micro-climate led to obvious vegetation variation between the pit and the pit slope at the tiankeng. The secondary collapse over the talus with mid-slope could conserve more water, which supported the water-demanding species in a high-quality niche. All the α diversity indices including Margalef (3.58), Shannon (2.47), Simpson (0.79) and Pielou (0.86) reached the maximum at the pit bottom edge with slight variability, and the maximum coefficient of variation was only 0.226. The β diversity index fluctuated greatly among the pit-pit, slope-pit, bottom edge. The Routledge and Whilson-Shmida indices showed the trends of decrease-increase-decrease, with the maximum values of 15.95 and 1.20, respectively. Species turnover demonstrated the upward trend overall, and the number of co-species was decreased. Plant diversity on each slope position was mainly related to the contents of total nitrogen, total phosphorus, available phosphorus and organic carbon in soil. Soil was the most important factor leading to the difference among slope positions.

[Evaluating the impacts of C9 leakage on bay ecosystem services: A case study in x bay]

The bay is the most susceptible area in the marine to human interference. It is of significance for maintaining ecological security of the bay to build an assessment framework of losses of bay ecosystem services caused by the C9 leakage event and evaluate it quantitatively. This study used market value, alternative cost, carbon tax and emergy analysis methods to construct a monetary value evaluation model for the lossses of key ecosystem services (food production, gas regulation, climate regulation, waste treatment, human health, nutrient cycling, species diversity maintenance, and recreation entertainment) caused by C9 leakage accident, and analyzed the losses of x-Bay ecosystem services. The results showed that total value of the losses of ecosystem services caused by C9 spill was 1.93×10⁸ yuan, and the monetary value of loss per unit area was 1.19×10⁸ yuan·km^-2, which was more than 2800 times of the general marine oil spill events. Among all the components, the loss of food production services accounted for 77.1% of the total, being much higher than the impact of the general marine oil spills on human production and life. Our results could provide references to the assessment of ecosystem services loss caused by toxic substances like C9, and to the government decision-making and national territory spatial planning.

[Scenario simulation of ecosystem service trade-offs in bay cities: A case study in Quanzhou, Fujian Province, China]

Bay cities have abundant land-sea resources and higher environmental carrying capacity. The high density of population and industry surrounding the bay makes bay cities a type of ecologically fragile areas. With Quanzhou, a typical bay city, as an example, we simulated the land use and landscape pattern change in 2030 based on multiple data sources (land use data, meteorological site data, topographic data and statistical data) using Logistic-CA-Markov coupling model to set natural scenarios, planning scenarios and protection scenarios. Four key ecosystem service (ES) including water retention, soil conservation, carbon sequestration (NPP), food supply and their trade-offs were calculated and predicted. Under the three scenarios, the area of cultivated land and construction land in Quanzhou City would increase in 2030. Forest land, grassland and water area would be reduced in varying degrees. The fragmentation of land use would be serious. In comparison with 2015, except for soil conservation service, water retention, carbon sequestrtion and food supply of Quanzhou City would decline to varying degrees in 2030. Ecosystem service function in natural scenario would be more decreased, with the decline under the protection scenario being lower than the planning scenario. In the protection and planning scenarios, the synergy between water conservation and soil conservation, water conservation and carbon sequestrtion, soil conservation and carbon sequestrtion in 2030 would be enhanced and the trade-offs would be weakened.

[Niche characteristics of understory dominant species of talus slope in degraded tiankeng]

We carried out niche monitoring and analysis of plant populations under the forest community in the talus slope ecotone of a typical moderate-degraded Bajiaxiantang tiankeng to provide scientific references for biodiversity conservation and vegetation restoration in degraded tiankeng area. The results showed that soil ammonium, available potassium, and available phosphorus signifi-cantly affected species distribution, which explained 37.4%, 32.8%, 29.3% of the total variation, respectively. With the change of talus slope of tiankeng (pit, uphill, mid-slope, downhill and pit bottom), life form of understory plants changed from evergreen and xerophytes to evergreen and hygro-mesophytes, with the niche overlap of herbs being larger than that of shrubs. Shrubs of Viburnum congestum and Campylotropis polyantha, and herbs of Arisaema erubescens and Arthraxon hispidus had wide ecological amplitude and strong resistance, which occupied the upper layer of the shrub and herb layers. Shrub Cornus oblonga and herb Geranium nepalense, Agrimonia pilosa lost the competitiveness with increasing soil alkalinity. Niche characteristics of understory dominant species in Bajiaxiantang were closely related to the canopy structure of mixed trees, ecological strategies of shrub and herb species, unique habitat of tiankeng, and the importance value of dominant species.

[Association of abnormal metabolic indices and its clustering with carotid intima-media thickness in childhood]

Objective: To examine the association of abnormal metabolic indexes and its clustering with carotid intima-media thickness (cIMT) in childhood. Methods: A convenient sampling method was used to conduct a cross-sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 240 children who had complete data of questionnaires, physical examinations, and blood biochemical tests were included for analysis. Covariance analysis was used to analyze the association of the single abnormal metabolic indices and its clustering with cIMT. The multivariable linear regression model was used to quantify the relationship between the number of abnormal metabolic indices and cIMT. Results: The age of 1 240 children was (8.9±1.5) years, and 657 boys accounted for 53.0%. The highest detection rate of abnormal metabolic indicators was found in abdominal obesity, accounting for 30.9% (203/657) of boys and 29.7% (173/583) girls respectively.The cIMT of boys and girls were (0.49±0.08) and (0.45±0.07) mm, respectively. After adjusting for sex, age, consumption of fruits, vegetables and carbonated drinks, sleep duration, screen time and physical activity, abdominal obesity, elevated blood pressure, total triglyceride and fasting glucose were associated with cIMT (all P values <0.001). Children with 0, 1, 2 and ≥3 abnormal metabolic indicators had cIMT values of (0.45±0.07), (0.48±0.08), (0.50±0.09) and (0.53±0.08) mm, respectively. That was, cIMT values increased with the number of abnormal metabolic indexes (P(trend)<0.001). Conclusion: Abdominal obesity, elevated blood pressure, total triglyceride, fasting glucose and clustering of the above factors are associated with cIMT.

[Soil microbial community characteristics in degraded karst tiankeng invaded by Eupatorium adenophorum.]

After invading the grand negative landform karst degraded tiankeng, Eupatorium adenophorum will affect the plant diversity, community succession and natural ecological restoration of degraded tiankeng by changing soil microbial community. Taking the degraded tiankeng "Bajiaxiantang" as the research area, the soil around E. adenophorum roots in different habitats was selected to explore the microbial community characteristics of E. adenophorum roots using the Biolog-ECO micro-plate method. The results showed that the invasion degree of E. adenophorum was in order of pit slope shrub-grassland > pit bottom grassland > pit slope forest > pit head shrub-grassland. The characteristics of E. adenophorum varied among different habitats due to habitat heterogeneity. The change of microbial community metabolic activity, dominance index, richness index and evenness index of E. adenophorum roots was closely related with the invasion degree, with significant diffe-rence between inside and outside of the tiankeng. Amino acids and polymers were the main carbon sources utilized by soil microorganism. The α diversity of herbaceous plants in different habitats were correlated with that of soil microbial community. The diversity of soil microbial community around E. adenophorum roots increased significantly with the increases of invasion level, which could form a microenvironment conducive to invasion and colonization. In the future, the degraded tiankeng would eventually form the climax community of underground forests with community succession and natural ecological restoration, which might result in the disappearance of E. adenophorum in the degraded tiankeng.

Minimally invasive treatment of old femoral fractures in adults

OBJECTIVE

Extensive incision associated with large-scale callus exfoliation and internal fixation is the common therapeutic approach employed by the majority of orthopaedists in the treatment of old femoral fractures. Inspired by the surgical techniques of intramedullary fixation and reduction by traction, the present study attempted to treat old femoral fractures with minimally invasive methods utilising the principles of biological osteosynthesis (BO).

METHODS

A retrospective analysis involving 16 patients with old femoral fractures treated with combined traction, small incision, limited callus treatment, reduction by leverage and intramedullary fixation was conducted. The operative effect was evaluated by the operation time, intraoperative blood loss, bone grafting, healing time of fractures during follow-up, VAS score, and Harris hip score.

RESULTS

Intraoperative observation revealed an average operation time of 1.53 ± 0.34 h and average blood loss of 268.13 ± 97.29 ml without bone grafting in all patients. All enrolled patients had outcomes resulting in effective fixation restoration of limb alignment. Of the 16 enrolled patients, 13 patients completed follow-up with an average follow-up time of 7.42 ± 3.29 months. The average healing time for proximal femoral fractures was 3 months. The average healing time of femoral shaft fractures was 4 ± 1.09 months; two of these cases took 4 months to heal, whereas 1 case demonstrated a delayed healing time of 6 months. The VAS score was 1.15 ± 1.70, 1 patient experienced sciatica, and the Harris hip score was 92.92 ± 5.42. There were no complications of malunion, nonunion or infection among any of the patients who completed follow-up.

CONCLUSIONS

Minimally invasive treatment is feasible for most patients with old femoral fractures of the trochanter and femoral shaft. This finding is consistent with BO principles, thereby providing a possible new method for the treatment of old femoral fractures.

BMP9 Promotes the Extracellular Matrix of Nucleus Pulposus Cells via Inhibition of the Notch Signaling Pathway

Intervertebral disk degeneration (IDD) is a common disease that is caused by degeneration of the nucleus pulposus (NP). One goal in the treatment of IDD is delaying or reversing the degeneration of NP via the transformation of exogenous genes. This study first investigated the role of BMP9 in the extracellular matrix (ECM) of nucleus pulposus cells (NPCs) and its mechanism. We found that BMP9 promotes the expression of ECM in NPCs, and the key molecules of Notch signaling, namely, NICD-1, hes and hey, and it was significantly altered in BMP9-transfected NPCs, which suggests that BMP9 may regulate the ECM via the Notch signaling pathway. We verified the expression of Notch ligands and receptors in NPCs infected with Ad-BMP9 and demonstrated a significant decrease in DLL1 and Notch1; then, NPCs were transfected with Ad-dnNotch1, Ad-Jagged1, and Ad-DLL1, and different multiple groups were established to further identify the ligands or receptors that affected ECM expression. The results demonstrated that Ad-dnNotch1, Jagged1 and DLL1 inhibited ECM expression, and dnNotch1 promoted expression. Therefore, we demonstrated that BMP9 promoted the expression of ECM in NPCs via inhibition of Notch1 and DLL1. This study provides a possible method for IDD treatment.

[Spatial pattern of plant community in original karst tiankeng: A case study of Zhanyi tiankeng in Yunnan, China]

Damaosi is one of original karst tiankengs with underground virgin forest in Yunnan Pro-vince. The spatial point pattern analysis and the woody individual spatial structure parameters, including the uniform angle index, mingling degree and storey index, were used to estimate spatial pattern of the tiankeng's underground forest community. We also analyzed the intraspecific spatial distribution characteristics and interspecific spatial association on the basis of the individual relative position information of plant community. The results showed that the spatial distribution of plant community in Damaosi tiankeng was random. Plant species in the forest were moderately mixed. The vertical stratification of this forest was relatively simple, with stable structure and mature development characteristics of climax forest community. The populations in this community were mainly clustered in spatial distribution, negatively correlated between species and stronger negative correlation on the same vertical level. The larger the difference in the vertical level, the smaller the space competition was. The negative correlation in space became weaker with the increases of spatial scale. Tiankeng ecosystem was one type of precious natural habitats and plant refuges with high ecological stability. The stable structure of tiankeng plant community had important implications for the ecological resto-ration in karst areas.

Investigating impact of waste reuse on the sustainability of municipal solid waste (MSW) incineration industry using emergy approach: A case study from Sichuan province, China

China has become the largest generator of municipal solid waste (MSW) in the world with its rapid urbanization, population growth and raising living standard. Among diverse solid waste disposal technologies, MSW incineration has been becoming an attractive choice. In terms of systematic point, an integrated MSW incineration system should include an incineration subsystem and a bottom ash (BA) disposal subsystem. This paper employed an extend emergy assessment method with several improved indicators, which considers the emissions' impact, to evaluate the comprehensive performances of an integrated MSW incineration system. One existing incineration plant in Yibin City, Sichuan Province, China, as a case study, is evaluated using the proposed method. Three alternative scenarios (scenario A: the incineration subsystem + the BA landfill subsystem; scenario B: the incineration subsystem + the concrete paving brick production subsystem using BA as raw material; scenario C: the incineration subsystem + the non-burnt wall brick production subsystem using BA as raw material) were compared. The study results reveal that the ratio of positive output is 1.225, 2.861 and 1.230, the improved environmental loading ratio is 2.715, 2.742 and 1.533, and the improved environmental sustainability index is 0.451, 1.043 and 0.803 for scenario A, B and C respectively. Therefore, reuse of BA can enhance the sustainability level of this integrated system greatly. Comparatively, scenario B has the best comprehensive performance among the three scenarios. Finally, some targeted recommendations are put forward for decision-making.

[Operative treatment of delayed acetabular fractures through combined anterior and Kocher-Langenbeck approaches]

Objective: To discuss the clinical outcomes of treating delayed acetabular fractures by combined anterior and posterior approach. Methods: A retrospective analysis was conducted of 31 delayed acetabular fractures from February 2012 to February 2017 in the First Affiliated Hospital of Chongqing Medical University, including 18 males and 13 females with age of 48.5 years(23 to 67 years) .The injury to the operation time was 35.9 days(22 to 183 days). Of these 31 cases, there were 6 cases of transverse and posterior wall fracture, 8 cases with anterior column+ posterior half transverse fracture, 12 cases with double column fracture and 5 cases of "T" type fracture according to Letournel-Judet classification.All fractures were treated combined anterior and Kocher-Langenbeck approaches, including 13 cases of ilioinguinal approach+ Kocher-Langenbeck(K-L approach), 4 cases of extensile acetabular approach, 7 cases of stoppa approach + K-L approach and 7 cases of side rectus femoris approach.Correlation was analyzed by Pearson correlation regression testing. Results: Follow up to August 2017, all patients were followed up with 36.0 months(from 6 to 55 months). As calculated, the restorational effect was positively with result of the X-ray film and the clinical effect(r=0.823, 0.856; both P<0.05). The evaluation was conducted with Matta's reduction criteria: there were 11 cases classified as anatomic reduction(35.5%), 13 cases as satisfactory reduction(41.9%), and 7 cases as unsatisfactory reduction(22.6%). Excellent and good rate was 77.4%. Functional reductions were categorized by the standard of Matta hip score: 8 excellent cases(25.8%), 11 good cases(35.5%), 8 fail cases(25.8%), and 4 poor cases(12.9%). Conclusion: The treatment of delayed acetabular fracture by combined anterior and posterior approach can fully exposure the anterior and posterior acetabular fcloumns, which is beneficial to the release and fixation of the old acetabular fractures.

[Interspecific relationships of dominant species in the grassland community of moderately degraded tiankeng of Yunnan, China.]

Karst tiankeng is a special grand negative landform. The environment of tiankeng inside are independent of that outside, showing a unique characteristics of plant community. Taking a moderately degraded tiankeng with good accessibility, Bajiaxiantang as the focus, the dominant species with importance value >1 were selected to clarify the interspecific association of 11 dominant species by the multi-disciplinary approach including the variance ratio (VR) of overall association, Φ² test, association coefficient (AC) and Spearman rank correlation coefficient. The results showed that VR of overall association in this grassland community was 1.377 (which was larger than 1), indicating that this community had overall significantly positive interspecific association. Given the great difference between the positive and negative association and significantly negative correlation between heliophiles and sciophiles, the community had independent distribution. The number of positive pairs of species (26) was less than that with negative correlation (29) in Spearman correlation analysis. Combined with the difference of tiankeng's micro-environment, dominant plant species of degraded tiankeng could be divided into three ecological groups. The grassland community in tiankeng showed circle distribution pattern.

Protective effect of glucosamine cyclohexyl ester on osteoarthritis in rat via targeting expressions of matrix metalloproteinase and tissue inhibitor of metalloproteinases-1

Purpose: To investigate the therapeutic effect of glucosamine cyclohexyl ester on osteoarthritis (OA) in a rat model.Methods: Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blot assays were used to analyze the effect of glucosamine cyclohexyl ester on changes in mRNA and protein expressions of matrix metalloproteinase and tissue inhibitor of metalloproteinases-1 in isolated rat chondrocytes, and in a rat model of OA. The rat model of OA was prepared by injecting monoiodoacetate to Sprague-Dawley rats via intra-articular route.Results: Treatment of the chondrocytes with glucosamine cyclohexyl ester for 48 h prevented interleukin-1 β (IL-1β)-mediated increases in mRNA and protein  expressions in matrix metalloproteinases-1, -3 and -13, and also blocked IL-1β-induced decreases in mRNA and protein expressions of tissue inhibitor of metalloproteinase-1. Glucosamine cyclohexyl ester treatment also blocked the onset of morphological changes such as irregular surface, adhesion of tissues andpresence of osteophytes in the femoral condyle surface of the OA rats. Mankin score for control, OA and glucosamine cyclohexyl ester treatment groups were 0.98 ± 0.15, 8.35 ± 0.88 and 2.39 ± 0. 67 (p = 0.002), respectively. Treatment of OA rats with glucosamine cyclohexyl ester also inhibited increases in the activities of matrix metalloproteinases-1, -3 and -13, and decreases of tissue inhibitor of metalloproteinase-1 mRNA and protein expressions. Treatment of chondrocytes and OA rats with IL-1β caused no significant changes in the levels of H3K27 and H4K8.Conclusion: These results show that glucosamine cyclohexyl ester prevents OA by targeting the expressions of matrix metalloproteinases-1, -3 and -13 and tissue inhibitor of metalloproteinases-1.Keywords: Metalloproteinases, Interleukin, Mankin score, Osteoarthritis, Cartilage

[Spatial patterns and influence factors of specialization in tea cultivation based on geographically weighted regression model: A case study of Anxi County of Fujian Province, China]

Anxi County, specializing in tea cultivation, was taken as a case in this research. Pearson correlation analysis, ordinary least squares model (OLS) and geographically weighted regression model (GWR) were used to select four primary influence factors of specialization in tea cultivation (i.e., the average elevation, net income per capita, proportion of agricultural population, and the distance from roads) by analyzing the specialization degree of each town of Anxi County. Meanwhile, the spatial patterns of specialization in tea cultivation of Anxi County were evaluated. The results indicated that specialization in tea cultivation of Anxi County showed an obvious spatial auto-correlation, and a spatial pattern with "low-middle-high" circle structure, which was similar to Von Thünen's circle structure model, appeared from the county town to its surrounding region. Meanwhile, GWR (0.624) had a better fitting degree than OLS (0.595), and GWR could reasonably expound the spatial data. Contrary to the agricultural location theory of Von Thünen's model, which indicated that distance from market was a determination factor, the specialization degree of tea cultivation in Anxi was mainly decided by natural conditions of mountain area, instead of the social factors. Specialization degree of tea cultivation was positively correlated with the average elevation, net income per capita and the proportion of agricultural population, while a negative correlation was found between the distance from roads and specialization degree of tea cultivation. Coefficients of regression between the specialization degree of tea cultivation and two factors (i.e., the average elevation and net income per capita) showed a spatial pattern of higher level in the north direction and lower level in the south direction. On the contrary, the regression coefficients for the proportion of agricultural population increased from south to north of Anxi County. Furthermore, regression coefficient for the distance from roads showed a spatial pattern of higher level in the northeast direction and lower level in the southwest direction of Anxi County.

Percutaneous fibrin gel injection under C-arm fluoroscopy guidance: a new minimally invasive choice for symptomatic sacral perineural cysts

Background

Symptomatic sacral perineural cysts are a common cause of chronic pain. Surgery is one choice for symptom relief but has a high risk of cyst recurrence and complications. As a simple and safe method to manage symptomatic sacral perineural cysts, C-arm fluoroscopy-guided fibrin gel injection may represent a new minimally invasive alternative. To evaluate the efficacy of this new method, we conducted a retrospective study of 42 patients.

Methods and Findings

From June 2009 to August 2012, a total of 42 patients with symptomatic sacral perineural cysts underwent C-arm fluoroscopy-guided percutaneous fibrin gel injection therapy. Patient outcomes in terms of improvements in pain and neurologic function were evaluated during a follow-up period of 13–39 months. The preoperative and postoperative pain severity were assessed according to a 10-cm visual analog pain scale, and imaging changes were evaluated by magnetic resonance imaging. We also assessed postoperative complications. Most patients experienced benefit from the procedure: twenty-five patients (59.5%) reported excellent recovery, eleven (26.2%) reported good recovery, three (7.1%) reported fair recovery, and three (7.1%) reported poor recovery. The overall effectiveness rate (excellent and good recoveries) was 85.7%. No serious postoperative complications were observed.

Conclusion

Percutaneous fibrin gel injection under C-arm fluoroscopy guidance could be a simple, safe and effective treatment option for symptomatic sacral perineural cysts.

Human mesenchymal stem cells as delivery of osteoprotegerin gene: homing and therapeutic effect for osteosarcoma

Biological treatments have been studied extensively and previous studies have proved that osteoprotegerin (OPG) can inhibit the development and progress of human osteosarcoma. However, the utility of biologic agents for cancer therapy has a short half-life, which can hardly deliver to and function in tumor sites efficiently. Mesenchymal stem cells (MSCs) have the potential to migrate to tumor sites. In this study, MSCs transfected with adenoviruses carrying the OPG gene (MSCs-OPG) were used via the tail vein to treat athymic nude mice (nu/nu) bearing osteosarcoma. In vivo and ex vivo images were used to validate the MSCs homing to tumors. The therapeutic effect for osteosarcoma was evaluated by observations on growth of tumors and bone destruction. The results showed that infected MSCs-OPG labeled with red fluorescent protein (RFP) can migrate to tumor sites and express OPG protein. The treatment by MSCs-OPG reduced the tumor growth and inhibited bone destruction in vivo. All these indicated that MSCs can deliver OPG to tumor sites, which could be a new direction of biological treatment for human osteosarcoma.

The serum glucan level and pathological changes of antifungal treatment for lower respiratory tract infection of Candida albicans

Due to the fact that Candida albicans colonizes in the upper respiratory tracts of healthy people, whether or not its isolation from airway secretions is sufficient to warrant treatment remains controversial. The animal models of immunosuppressive rats with pulmonary candidiasis were established by the intratracheal inoculating suspensions of C. albicans, and the animals were divided into the following three groups: (1) antifungal treatment group, (2) saline control group, and (3) blank control group. We noted the following in our studies: (1) The fungal load of the saline control group gradually increased such that it was higher than those of the antifungal treated group and was significant from the fourth day of treatment (P < 0.01). (2) The serum (1,3)-β-D-glucan (BG) in the saline control group also gradually increased so that it was significantly higher than found with the treated group by the sixth day of treatment (P < 0.05), and in fact, the rank of pulmonary colony count and BG in the two groups at different time points showed an almost perfect linear correlation. (3) The median survival period of the rats in the antifungal treated group and saline control group was 15 and 8 days respectively, no rats died in the blank control group. (4) The lung lesions from the saline control group gradually became more aggravated than those in the antifungal treated group; no significant pathological changes were found in the blank control group. Antifungal treatment (micafungin) is capable of efficaciously decreasing the lung fungal burden, and continuous monitoring of BG is useful for the evaluation of therapeutic effect of antifungals. Infection of C. albicans with associated pathological damage implies the need for antifungal therapy.

SIRT1 protects against apoptosis by promoting autophagy in degenerative human disc nucleus pulposus cells

SIRT1 could protect degenerative human NP cells against apoptosis, and there were extensive and intimate connection between apoptosis and autophagy. Up to now, the role of autophagy in the process of human IVD degeneration is unclear. We sought to explore the relationship between autophagy and human IVD degeneration and to understand whether autophagy is involved in the protective effect of SIRT1 against apoptosis in NP cells. Our results showed that the autophagosomes number, the mRNA level of LC3 and Beclin-1, the protein expression of LC3-II/I and Beclin-1, decreased in NP from DDD. Resveratrol could increase the protein expression of LC3-II/I and Beclin-1, and reduce apoptosis in degenerative NP cells. In contrast, the protein levels of LC3-II/I and Beclin-1 were down-regulated and apoptosis level was significantly up-regulated in treatment with nicotinamide or SIRT1-siRNA transfection. Further analysis identified that the expression of cleaved Caspase3 and apoptosis incidence significantly increased with the pretreatment of bafilomycin A, whether resveratrol was added or not. These suggested that autophagy may play an important role in IVD degeneration, and SIRT1 protected degenerative human NP cells against apoptosis via promoting autophagy. These findings would aid in the development of novel therapeutic approaches for degenerative disc disease treatment.

Targeting BMP9-promoted human osteosarcoma growth by inactivation of notch signaling

Osteosarcoma (OS) is the most common primary malignancy of bone and is usually associated with poor prognosis due to its high incidence of metastasis and chemoresistance. Molecular pathogenesis of OS is poorly understood. We previously showed that OS cells are refractory to BMP9-induced osteogenesis and respond favorably to proliferation and tumor growth. Here we investigate if Notch signaling mediates the BMP9-promoted cell proliferation and tumor growth of human osteosarcoma (OS). We find that the expression of Notch1, Notch2, Notch3, DLL1, JAG1 and JAG2 is readily detected in most of the tested OS cell lines. BMP9-promoted OS cell proliferation, migration, and cell cycle S/G2 progression are effectively inhibited by a dominant-negative mutant of Notch1 (dnNotch1) or the γ-secretase inhibitor Compound E (ComE). Furthermore, BMP9-promoted tumor growth and osteolytic lesions in vivo are significantly inhibited by dnNotch1. BMP9 up-regulates the expression of Notch1, Notch3, DLL1, and JAG1 in OS cells. Accordingly, BMP9 stimulation induces a nuclear accumulation of NICD, which is blocked by ComE. Our results demonstrate that BMP9-promoted OS proliferation and tumor growth is at least in part mediated by Notch signaling, suggesting that osteogenic BMPs may function as upstream regulators of Notch signaling in OS tumorigenesis. Thus, pharmacologic intervention of Notch signaling may be explored as a new therapeutic strategy for human OS tumors.

Reversibly Immortalized Mouse Articular Chondrocytes Acquire Long-Term Proliferative Capability While Retaining Chondrogenic Phenotype

Cartilage tissue engineering holds great promise for treating cartilaginous pathologies including degenerative disorders and traumatic injuries. Effective cartilage regeneration requires an optimal combination of biomaterial scaffolds, chondrogenic seed cells, and biofactors. Obtaining sufficient chondrocytes remains a major challenge due to the limited proliferative capability of primary chondrocytes. Here we investigate if reversibly immortalized mouse articular chondrocytes (iMACs) acquire long-term proliferative capability while retaining the chondrogenic phenotype. Primary mouse articular chondrocytes (MACs) can be efficiently immortalized with a retroviral vector-expressing SV40 large T antigen flanked with Cre/loxP sites. iMACs exhibit long-term proliferation in culture, although the immortalization phenotype can be reversed by Cre recombinase. iMACs express the chondrocyte markers Col2a1 and aggrecan and produce chondroid matrix in micromass culture. iMACs form subcutaneous cartilaginous masses in athymic mice. Histologic analysis and chondroid matrix staining demonstrate that iMACs can survive, proliferate, and produce chondroid matrix. The chondrogenic growth factor BMP2 promotes iMACs to produce more mature chondroid matrix resembling mature articular cartilage. Taken together, our results demonstrate that iMACs acquire long-term proliferative capability without losing the intrinsic chondrogenic features of MACs. Thus, iMACs provide a valuable cellular platform to optimize biomaterial scaffolds for cartilage regeneration, to identify biofactors that promote the proliferation and differentiation of chondrogenic progenitors, and to elucidate the molecular mechanisms underlying chondrogenesis.

Noggin resistance contributes to the potent osteogenic capability of BMP9 in mesenchymal stem cells

Mesenchymal stem cells (MSCs) are multipotent progenitors and can differentiate into osteogenic, chondrogenic, and adipogenic lineages. Bone morphogenetic proteins (BMPs) play important roles in stem cell proliferation and differentiation. We recently demonstrated that BMP9 is a potent but less understood osteogenic factor. We previously found that BMP9-induced ectopic bone formation is not inhibited by BMP3. Here, we investigate the effect of BMP antagonist noggin on BMP9-induced osteogenic differentiation. BMP antagonists noggin, chording, gremlin, follistatin, and BMP3 are highly expressed in MSCs, while noggin and follistatin are lowly expressed in more differentiated pre-osteoblast C2C12 cells. BMP9-induced osteogenic markers and matrix mineralization are not inhibited by noggin, while noggin blunts BMP2, BMP4, BMP6, and BMP7-induced osteogenic markers and mineralization. Likewise, ectopic bone formation by MSCs transduced with BMP9, but not the other four BMPs, is resistant to noggin inhibition. BMP9-induced nuclear translocation of Smad1/5/8 is not affected by noggin, while noggin blocks BMP2-induced activation of Smad1/5/8 in MSCs. Noggin fails to inhibit BMP9-induced expression of downstream targets in MSCs. Thus, our results strongly suggest that BMP9 may effectively overcome noggin inhibition, which should at least in part contribute to BMP9's potent osteogenic capability in MSCs.

Characterization of scaffold carriers for BMP9-transduced osteoblastic progenitor cells in bone regeneration

Successful bone tissue engineering at least requires sufficient osteoblast progenitors, efficient osteoinductive factors, and biocompatible scaffolding materials. We have demonstrated that BMP9 is one of the most potent factors in inducing osteogenic differentiation of mesenchymal progenitors. To facilitate the potential use of cell-based BMP9 gene therapy for bone regeneration, we characterize the in vivo osteoconductive activities and bone regeneration potential of three clinically used scaffold materials, type I collagen sponge, hydroxyapatite-tricalcium phosphate (HA-TCP), and demineralized bone matrix (DBM), using BMP9-expressing C2C12 osteoblastic progenitor cells. We find that recombinant adenovirus-mediated BMP9 expression effectively induces osteogenic differentiation in C2C12 cells. Although direct subcutaneous injection of BMP9-transduced C2C12 cells forms ectopic bony masses, subcutaneous implantation of BMP9-expressing C2C12 cells with collagen sponge or HA-TCP scaffold yields the most robust and mature cancellous bone formation, whereas the DBM carrier group forms no or minimal bone masses. Our results suggest that collagen sponge and HA-TCP scaffold carriers may provide more cell-friendly environment to support the survival, propagation, and ultimately differentiation of BMP9-expressing progenitor cells. This line of investigation should provide important experimental evidence for further preclinical studies in BMP9-mediated cell-based approach to bone tissue engineering.

Endoplasmic reticulum (ER) stress inducible factor cysteine-rich with EGF-like domains 2 (Creld2) is an important mediator of BMP9-regulated osteogenic differentiation of mesenchymal stem cells

Mesenchymal stem cells (MSCs) are multipotent progenitors that can undergo osteogenic differentiation under proper stimuli. We demonstrated that BMP9 is one of the most osteogenic BMPs. However, the molecular mechanism underlying BMP9-initiated osteogenic signaling in MSCs remains unclear. Through gene expression profiling analysis we identified several candidate mediators of BMP9 osteogenic signaling. Here, we focus on one such signaling mediator and investigate the functional role of cysteine-rich with EGF-like domains 2 (Creld2) in BMP9-initiated osteogenic signaling. Creld2 was originally identified as an ER stress-inducible factor localized in the ER-Golgi apparatus. Our genomewide expression profiling analysis indicates that Creld2 is among the top up-regulated genes in BMP9-stimulated MSCs. We confirm that Creld2 is up-regulated by BMP9 in MSCs. ChIP analysis indicates that Smad1/5/8 directly binds to the Creld2 promoter in a BMP9-dependent fashion. Exogenous expression of Creld2 in MSCs potentiates BMP9-induced early and late osteogenic markers, and matrix mineralization. Conversely, silencing Creld2 expression inhibits BMP9-induced osteogenic differentiation. In vivo stem cell implantation assay reveals that exogenous Creld2 promotes BMP9-induced ectopic bone formation and matrix mineralization, whereas silencing Creld2 expression diminishes BMP9-induced bone formation and matrix mineralization. We further show that Creld2 is localized in ER and the ER stress inducers potentiate BMP9-induced osteogenic differentiation. Our results strongly suggest that Creld2 may be directly regulated by BMP9 and ER stress response may play an important role in regulating osteogenic differentiation.